Are You Iron Deficient? - Ask a Nutritionist

May 25, 2023

Iron plays a very important role in our bodies. From DNA synthesis to carrying oxygen all over the body. So what happens when you aren't getting enough iron? Tune in to this week's episode of Ask a Nutritionist with Britni to find out if you have any of the symptoms of an iron deficiency.

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Welcome to the “Ask a Nutritionist” podcast, brought to you by Nutritional Weight and Wellness. We are thrilled to have you join us today as we discuss the connection between what you eat and how you feel, and share practical real life solutions for healthier living through balanced nutrition. Now let's get started.

BRITNI: Good morning and welcome to Dishing Up Nutrition's new midweek segment called “Ask a Nutritionist”. I am Britni Vincent, a Registered and Licensed Dietitian. And on today's show, brought to you by Nutritional Weight and Wellness, I will be answering a nutrition question that we've received from one of our Dishing Up Nutrition listeners. And the topic or the question for today is, “I would like to learn more about iron deficiency.” I think this is a great topic because I see it affecting a lot of my clients. And through listening to this, maybe some of you will discover it's an issue for you or learn how to overcome it.

What is iron deficiency?

So let's start just by defining what iron deficiency is. So it's defined as the decrease of the total content of iron in the body. And then there's iron deficiency anemia, so that is more severe and that is a condition where the lack of iron in the body will lead to a reduction in the number of red blood cells. So if you have iron deficiency anemia, your symptoms are likely going to be more severe.

What is iron’s role in the body?

And then let's talk about what is iron's role in the body? So it's a mineral that is needed for growth and development. It's used in a variety of different processes in the body. One of the major roles that it plays is to make hemoglobin, which is a protein in our red blood cells that carries oxygen from our lungs to all different areas of the body. Iron also helps to provide oxygen to our muscles as well. Your body also needs iron to make certain hormones as well as it, it is used in DNA synthesis, so tons of different roles in the body. And without enough iron, you, you are not getting enough oxygen carried throughout the body. You're not making enough of certain hormones. You're not using that DNA synthesis as well. So it does have a huge effect on the body if you are iron deficient.

Signs and symptoms of iron deficiency

So signs and symptoms can include fatigue and in some people this is really extreme fatigue. And I have had clients they just feel really poorly on a daily basis. And that can include weakness, pale skin, chest pain, fast heartbeat or shortness of breath, headache, dizziness, lightheadedness. That's another common one. Cold hands or feet, inflammation or soreness of your tongue, brittle nails, poor appetite. This is especially true in infants and children with iron deficiency anemia. Chewing ice is another sign. I know that is a super strange one, but people that are really craving and seeking out to chew ice, that's a major red flag that you most likely have iron deficiency or iron deficiency anemia.

Labs that can indicate iron deficiency

So your doctor might look at a variety of different labs to diagnose this and likely you're going to get a CBC ordered, which is a complete blood count. You'll likely get an hemoglobin, iron and sometimes a ferritin ordered. And the CBC also checks the number of red blood cells, white blood cells and platelets. So when you're looking at your labs, and maybe you want to pull up MyChart as you're listening right now, some signs in your lab work that could point to iron deficiency would be low hemoglobin and hematocrit, low MCV, which is mean cellular volume, low serum iron, high transferrin, or total iron binding capacity, low iron saturation, and then low ferritin.

So I want to touch on this ferritin a little bit more. So ferritin is an iron storage marker. And let's say you have been tested for iron deficiency and you don't have it, but yet you have some of these signs and symptoms that I described. I would encourage you to request a ferritin because when you are iron deficient, your ferritin could be really low. But some of these other lab markers might not be out of range yet, but if you have low ferritin, you can still feel really poorly. And again, that's going to affect many different areas of our body.

So optimally, you want to see your ferritin above 75. And I think people feel the most symptoms of a low ferritin when you're below 20. You know, I have seen as low as four. So you can imagine that individual was not feeling well at all. And when to request these tests from the doctor: you know, some of these, the CBC is often just routine in a physical as well as a hemoglobin. But if, if you are, again, feeling a lot of these symptoms that I mentioned, or if you have switched to a real food diet and you haven't found that your energy has increased that much, then I would say that's probably a big sign that there's something else underlying that is causing that fatigue. So just ask, ask your doctor to get these tested. And again, I would request that ferritin in addition to everything else, just to rule that out.

Why might someone be iron deficient?

And reasons why people are iron deficient: there's, there's several here. So the obvious is just lack of iron in the diet. And we see that more in vegetarians, vegans. Young children are more likely to be iron deficient. Women who have heavy menstruation: that can cause iron deficiency. If you are eating adequate amounts of iron rich foods, and I would say if you're eating animal protein at your meals, then that would mean you're eating enough iron rich foods. And in that case, if you still have iron deficiency, that would be a sign that you're probably not absorbing your food very well and lack of absorption that could be caused by celiac, which is an autoimmune condition in which gluten causes damage to your intestinal tract and causes you to not be able to absorb your nutrients very well.

Similarly, but not as severe, a gluten sensitivity can also affect your ability to absorb your nutrients. Low stomach acid is another big connection to iron deficiency. So the majority of people that have acid reflux do have low stomach acid. I know that is counterintuitive. We have tons of radio shows or articles about this topic of acid reflux that you could read more about that. And then especially if you have been on antacids, that causes your stomach acid to become even lower. That is going to affect your ability to absorb and digest your, your food properly. Blood loss can be a sign of iron deficiency. And iron deficiency is also very common in pregnancy and that is monitored very closely during pregnancy at your routine checkups.

How to overcome iron deficiency

So all of these reasons for iron deficiency we help our clients with and we can in a lot of cases help you to naturally overcome iron deficiency. The obvious ways of this solution are to again, increase your iron rich foods if you're not eating enough of them, which I'm going to talk about, and then rule out if it is an issue of absorption. And working with a nutritionist is a great way to discover what might be going on in your body that's causing that iron deficiency.

Iron-rich food sources

So talking about food sources, there are two different types of iron that are found in our food. One is called heme and one is non-heme. Iron from animal sources is heme iron, and that's only found in animal flesh. So meat, poultry, seafood. Non-heme iron is found in plants, you know, some whole grains, nuts, seeds, legumes, leafy greens. Heme iron is a lot more bioavailable. So you're absorbing about 25 to 30% of that iron versus non-heme iron from the plant sources, you are only absorbing somewhere between one and 10% of that iron.

So listing out more of these food sources: meat, beef, pork, lamb, especially organ meats. Liver’s a great source of iron; poultry, chicken, turkey, duck; dark meat is especially higher in iron, fish, shellfish, sardines, anchovies. Those would all be great sources of iron as well. And then for plant sources, leafy greens, members of the cabbage family like broccoli, kale, turnip greens, collard greens, legumes like lima beans, peas, pinto beans, and black-eyed peas are are good sources.

And it is smart to, especially with these non-heme iron foods, to combine that with the food that is rich in vitamin C and and that helps with the absorption process. So that could be as simple as just squeezing some lemon juice on these plant sources or eating some tomato with it, peppers, things like that to get a little bit of vitamin C with it. And as far as supplementation goes, I would not recommend supplementing unless you know your number, because getting too much iron is problematic and can cause free radicals in the body. So never supplement with iron unless you know your level.

So let's say that you start supplementing after you find out you’re iron deficient. I would make sure to get those labs rechecked in a few months. And then again, once you get your iron up and you figure out what is at the root that's causing the iron deficiency, you should not need to take the iron supplements long term. As far as supplementing with iron, there are some forms that are more absorbable for the body. We have one that is called just Iron on the Nutrikey website and it is a chelated form of iron, meaning that it is bound to something to help the absorption process. And by doing that, that helps to reduce any of those negative side effects from iron supplementation. Again, make sure that you're monitoring those labs so you're not getting too much iron. I know this can be a little bit of a complicated topic, so I hope that I provided you some more in-depth information today.

Thank you so much for listening to Dishing Up Nutrition’s “Ask a Nutritionist”. If you have a nutrition question you would like us to answer, we invite you to join our Dishing Up Nutrition Facebook community by searching Dishing Up Nutrition on Facebook. This private group is moderated by Nutritional Weight and Wellness nutritionists and nutrition educators, and provides our Dishing Up Nutrition listeners with a safe, supportive community to ask questions, share ideas, and get inspired. Once you're a member of our community, we invite you to join the conversation and share your questions with us. So please don't be shy. If you have a question, just let us know and we look forward to hearing from you.

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